Fara S Ellis, RAS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

E0703181755 Issued in CA

Practice address

16940 Highway 14 Ste F
Mojave, CA 93501-1238

Phone

(661) 824-5020

Fax

(661) 824-5026

NPI assigned

Jun 28, 2011

Last updated

Aug 31, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472601600000",
    "number": "1053608091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21521 WESTWOOD BLVD",
            "city": "TEHACHAPI",
            "state": "CA",
            "postal_code": "935619445",
            "telephone_number": "661-822-5171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16940 HIGHWAY 14 STE F",
            "city": "MOJAVE",
            "state": "CA",
            "postal_code": "935011238",
            "telephone_number": "661-824-5020",
            "fax_number": "661-824-5026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "FARA",
        "middle_name": "S",
        "credential": "RAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-28",
        "last_updated": "2016-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "E0703181755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• College Community Services (Clarvida)
• Community Action Partnership of Kern
• Isabel Day
• Dependable Home Health, Inc
• Tan Minh DO
• Michael Angel Esparza I
• Jessica Rae Fada, OTHER
• Mychal Anthony Fimbres Sr.
• Carina Galindo
• David Garcia

• Addiction (Substance Use Disorder) Counselor in Mojave, CA
• Providers in Mojave, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.